Talk it out: The science behind therapy and how it can help you

New class expectations, new living situations, and navigating newfound independence can give us all the feels—from super psyched to super stressed. Even if you’re loving your student life, dealing with all the stressors that come with college can be a lot to handle. According to experts, the best time to handle that stress is now.

“Taking care of our mental health is vital to functioning well on a day to day basis, maintaining good relationships and reaching our goals. It also helps us intervene early before things take a turn for the worse,” said Ashley Grundmayer, therapist at Nebraska Medicine – University Health Center Counseling and Psychological Services on the University of Nebraska-Lincoln campus. “Addressing our mental well-being is one of the kindest things we can do for ourselves.”

Now really is the time to start tuning into your mental health—the majority of mental health issues appear to begin between the ages of 14 and 24, according to a review of the World Health Organization World Mental Health surveys and other research (Current Opinion in Psychiatry, 2007). But help is available. Along with methods like mindfulness and meditation, talking to a therapist (such as a counselor, psychologist, or psychiatrist) can be a super-effective way to manage any mental health concern you may be facing or just a way to get extra support during times of stress, challenge, celebration, or change.

There’s a ton of research on how effective therapy really is—a 2015 meta-analysis of 15 studies of college students with depression found that outcomes were nearly 90 percent better for those who received therapeutic treatment than for those in control groups, most of whom received no treatment (Depression and Anxiety).

One of the most common and effective therapies is cognitive behavioral therapy (CBT), a short-term, goal-oriented therapy where a pro helps you find practical ways to deal with specific problems.

The goal of CBT is to help you change or reframe certain thought processes—the idea is that by changing your attitude about something, you can change your behaviors. For example, if you think something like, “I’m terrible at chemistry, so I know I’m going to fail this test—there’s no use studying,” you probably won’t ace your test. CBT can help you shift your thinking to something more like, “I know chemistry is really hard for me, but studying will help me do better.”

And it works. There’s strong evidence that this therapeutic technique can help you handle just about anything you might have going on, according to a 2012 analysis of over 200 studies on CBT published in Cognitive Therapy and Research. The researchers found that CBT was effective for people struggling with anxiety, bulimia, anger issues, stress, and a number of other mental health issues.

OK, so we know that therapy is an essential and effective tool for keeping your mental health at its peak, but making that first appointment can feel intimidating. It doesn’t have to be. Our experts break down the therapy basics so you can embrace whatever you need to feel your best. Here’s what the pros want you to know.

Surveys show it’s not out of the ordinary to see a therapist—55 percent of college students have used campus counseling services, according to a 2012 report from the National Alliance on Mental Illness. If you feel uncomfortable with the idea of going to see a therapist, you’re not alone—and that’s completely normal says Tricia Besett-Alesch, PhD, licensed pyschologist and associate psychology manager at Nebraska Medicine – University Health Center Counseling and Psychological Services on the University of Nebraska-Lincoln campus. “Most students are nervous about seeing a counselor. We want the students to know we are here to support them. No concern is too big or small. Our goal is to help them make the changes they need to be successful in their personal lives and academically at the University of Nebraska-Lincoln.”

“Students frequently share that they’ve delayed coming into counseling because they don’t ‘just want to talk about their feelings.” Dr Besett-Alesch says. Again, that’s totally normal. But going to therapy isn’t just about talking about how you feel; it’s also about walking away with real tools you can use in your life. “Therapy is also about striving for change, and change happens when we start doing things differently – finding new healthy ways to cope and building skills to solve problems as they arise,” Grundmayer says.

Just like hitting the gym is good for everyone’s physical health—not just those with diabetes or heart disease—seeing a therapist can benefit everyone’s mental health.

But really, any time is a good time to go. While anxiety and depression are still the most common reasons students seek counseling, according to a 2016 annual report from the Center for Collegiate Mental Health, you don’t have to be in the midst of a crisis or feel like you’re nearing a breakdown to see a pro—seeing a therapist can be helpful even when things are all good. “There are usually warning signs that indicate things are going downhill,” Grundmayer says. “Recognizing those signs and intervening early is always better than waiting for rock bottom before seeking help.” In other words, don’t wait for an emergency to take care of your mental health. “When an unexpected life events happens, we want our students to already be equipped to a strong set of coping skills. Positive mental health protects against the impact of unfortunate events,” adds Dr. Besett-Alesch.

Student perspective

“Being able to just have someone to really listen has promoted a lot of self-discovery. I trust my therapist with everything and I feel like he genuinely cares about what I have to say. He asks me questions that make me think about why I feel and do the things that I do. Once I know where something comes from, I can change it. It’s easier said than done, but it’s not something I think I could do on my own.”—Second-year undergraduate student, University of Alabama

Real talk: College is full of huge life changes. “Stress can arise even in the midst of positive and exciting changes,” Grundmayer says. Luckily, therapists are particularly skilled at helping their clients deal with these transitions. “Having someone to help you navigate and adjust to these changes as they come can be helpful,” she says. While you’re dealing with a new set of responsibilities and expectations (everything from picking the right major to sorting through awkward roommate issues), a therapist can help you pinpoint how all the changes are impacting you and sort through the onslaught of emotions that everyone feels during this time.

Therapists aren’t one-size-fits-all—sometimes you have to try a few before you find the right fit. Don’t get turned off if your first therapy appointment isn’t super helpful—if something feels uncomfortable, listen to your gut, but don’t give up.

Finding that fit with a therapist is just as important for the outcome as the actual therapeutic technique, according to findings presented in Psychotherapy Relationships That Work (Oxford University Press, 2004). The research analysis found that three key things had a measurable positive impact on the outcome of individual therapy: 1) the strength of your collaborative relationship with your therapist—aka are you on the same page and making goals for your treatment together?; 2) your therapist’s ability to empathize or see where you’re coming from; and 3) the degree to which you and your therapist outline goals and reevaluate them together.

In other words, to get the most out of a therapy session, take the time to find someone you feel like you’re on the same page with, who gets you, and who’s willing to listen to your goals for therapy and help you develop them.

What populations do you specialize in? (While all therapists take on different types of clients, some specialize in specific groups such as working with people of color or those who’ve been marginalized in some way.)

How do you invite all aspects of your client into the room? (It’s important to know how your therapist will address all aspects of your culture, says Dr. Crawford. “You want to know that you can talk to your therapist about all parts of who you are.”)

What are your beliefs about how people change?

What’s your goal for ending therapy? (Some therapists believe therapy is an ongoing thing that you never really graduate from, while others see it as a tool to resolve a specific challenge. Make sure their goals line up with yours, and if not, ask if you can redefine them together.)

To find a therapist, start with Nebraska Medicine – University Health Center Counseling and Psychological Services, located on the University of Nebraska-Lincoln campus. The first four counseling sessions per academic lifetime are no cost to students who pay student fees. To make an appointment, call 402.472.5000

Check with your insurance provider to see whether you need a referral to see a psychologist or counselor. If so, you may need to make an appointment with a primary care provider, whether at home or at Nebraska Medicine – University Health Center, to ask for one. Once you have the referral (if needed), you can seek out a therapist in a number of ways:

Call Nebraska Medicine – University Health Center Counseling and Psychological Services to schedule an appointment with a therapist on staff.

Ask friends and family members if they have a therapist they recommend.

Call your insurance company or use their online services to find a list of therapists who are covered by your plan. If you get a personal recommendation from someone, you’ll also need to check that they’re covered under your insurance plan.

Once you have a name or a list of names and you’ve checked that the providers are covered by your insurance plan, call Nebraska Medicine – University Health Center at 402.472.5000 to make an appointment or each therapist on your list and leave a message to ask if they’re accepting new patients and to call you back with their available hours. When you hear back from the therapist, you may want to discuss what you’re looking to get out of treatment, what days and times you’re available to meet, and what their fees are—confirm that they take your insurance (it never hurts to double check this)—and ask about their training and make sure they’re licensed. Sometimes it can take a few tries to find someone whose schedule works with yours, but don’t let that deter you.

“Counseling is incredibly effective in helping you acquire a better understanding of yourself. In doing this, you also acquire healthier habits,” says Dr. Besett-Alesch. For example, if you have trouble getting up in time to make that optional early-morning lecture, but then you beat yourself up about missing it, a therapist can help you identify what you really value and then help you make decisions based on that. “Gaining an objective, outsider perspective can be helpful when you need a sounding board or someone to bounce ideas off of,” Grundmayer says. “A therapist’s primary goal is to help you reach your goals and live your best life.”

Once you’ve identified what’s really important to you, a therapist can help give you the tools to make your value-driven goals a reality. “Nothing changes if nothing changes,” Grundmayer says. “When you’re ready for change in your life, therapy can be helpful in order to find some guidance and direction on how to begin making these vital changes.”

You may be worried that all that talking might get out or that your therapist might tell your advisor or RA about what you’re struggling with. “A mental health provider cannot share counseling information unless the student is an imminent threat to themselves or others,” says Dr. Besett-Alesch. “The counseling relationship is dependent upon honesty and maintaining trust.” Bottom line: Unless they believe you’re in imminent danger (e.g., at risk of being seriously harmed or harming yourself or others), they can’t share what you say.

In short, everyone can benefit from talking to a therapist. “Just like it can be helpful to get a regular check-up from the doctor on your physical health, going to therapy can help you check in on your mental well-being,” Grundmayer says. “It can be a chance to reflect on your life, how things are going and your goals for the future.” Whether you’re wrestling with anxiety and depression or mildly stressed about finding a summer internship, seeing a therapist can help—even if it’s just for a few sessions. (According to the CCMH report, the average student who uses campus psychology services attends between four and five sessions.)

Student perspective

“Therapy was a good way to talk through anything weighing on my mind. My therapist was very understanding, kind, and, of course, confidential. I’d recommend going to counseling services to everyone.”—Third-year undergraduate student, Elizabethtown College, Pennsylvania

National Alliance on Mental Illness. (2012). College students speak: A survey report on mental health. Retrieved from https://www.nami.org/About-NAMI/Publications-Reports/Survey-Reports/College-Students-Speak_A-Survey-Report-on-Mental-H.pdf

National Alliance on Mental Illness. (n.d.). Mental health facts: Children and teens. Retrieved from https://www.nami.org/getattachment/Learn-More/Mental-Health-by-the-Numbers/childrenmhfacts.pdf